A (perfect) mature smile

Past traditional age for braces, some adults still choose procedure

Past traditional age for braces, some adults still choose procedure

August 18, 2008|By CRYSTAL SCHELLE

Marian Gale, 57, was looking to achieve that Hollywood smile. Marti Grahl, 42, wanted to correctly bite into a piece of pizza. For both, accomplishing their dreams meant something that is commonly considered a rite of adolescence: braces.

Dr. Tim Wilson, of Wilson Orthodontics in Hagerstown, says about 15 percent of his patients are adults. More adults today, he says, are opting for braces.

"And during the last five years, wearing braces has become even more socially accepted," he says.

The American Association of Orthodontists reports that about 20 percent of orthodontic patients are 18 or older. The number of adult patients has increased nearly 33.5 percent in the last 10 years.

Wilson says many adult patients have told him that, when they were children, their parents couldn't cover the expense of braces. The AAO reports more adults are choosing to wear braces to improve their dental health and appearance - something that Wilson finds to be true.


The goal of braces, he says, is to have "an aesthetic and functional bite that is in harmony with the facial musculature." The idea, he says, is to have teeth in the right position to be attractive. Wilson says about 75 percent of his adult patients are after a beautiful smile.

"A majority of adults treated are for cosmetic reasons," he says.

The other 25 percent of his patients, he says, have other dental concerns that their dentists believe need to be addressed as an orthodontic problem.

Different techniques for straightening

There are several types of braces - the standard orthodontic bracket, the ceramic bracket, the self-ligating bracket and Invisalign, the alternative to braces. Wilson says many adults come in hoping they will be fitted with Invisalign, but most don't meet his criteria.

Gale, of Sharpsburg, had already had braces when she was 30. After the braces were removed, her orthodontist told her she needed to continue to wear a retainer at night. But after a few years, she stopped.

So last year, when she was looking for a perfect smile, she visited a cosmetic dentistry practice.

"He told me, 'Get your teeth straightened,'" she says.

Wanting to achieve her Hollywood smile, Gale made an appointment with Wilson. She hoped she would qualify for Invisalign. Luckily, she says, she did.

Gale says her dentist made an impression of her teeth that was sent to Invisalign. The company then maps out her progress with Wilson, fitting her with clear retainers, called "trays," that fit over her top and bottom teeth. She says she gets three trays per visit and each tray lasts two weeks. Unlike braces, they can be popped out at any time.

"I had no discomfort," she says.

Gale was fitted in December 2007 and six months later was finished with the treatment. "It's just an amazing natural smile," she says.

Challenges facing adult patients

Wilson says the biggest problem facing adult patients is that it takes longer for braces to do their job.

"Teeth move a little slower as adults," he explains.

That's the reason why most adults' time in braces is quarter to one-third longer than it would if they were teens, he says.

Grahl, of Smithsburg, had been having problems with her teeth since she was a teen. Looking at her, she says, one couldn't tell that her bite was off. "In family photos, it looked like I had an opened-mouth smile, but I really couldn't put my teeth together," she says.

The major problem was caused by what she found out later to be a congenital defect of her jawbone. Doctors told her parents that it could be fixed if they broke Grahl's jaw, then wired it shut before she even had braces. Her parents didn't think it was necessary at the time. "They thought I looked fine," she says.

But as an adult, she found it was difficult to chew certain foods. She also had to have root canals and two crowns.

When her oldest daughter got her braces in 2001, Grahl, then 36, decided that maybe it was time to see if braces were for her. She approached Ron Toothman, her daughter's dentist, about the braces.

She says he first referred her to an oral surgeon to make her jaw more pliable so that the braces would do the job. At that time, she and her doctor discussed putting on Damon brackets, which are self-ligating braces. The brackets click open and shut for easier wire changes. Grahl describes it as "beads on a string" where the wires are more fluid within the brackets.

After her teeth were corrected, Grahl lost weight because, she says, she was able to process her food. "I'd bite into a sandwich and take a clean bite," she says.

She also noticed a change in her speech. The "hiss" she would give when she made an "s" sound was gone.

Grahl stresses that for her, getting braces wasn't for cosmetic reasons. Her insurance paid for the surgeries, but not for the braces, which cost nearly $6,000.

Two of her three daughters have now had braces. Grahl says she can sympathize with them.

"I now have so much more respect for grumpy teenagers who have just gotten their wires tightened," she says.

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